Individual provider Active NPI

Marina Vaynshteyn, NP

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1639220528
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303507 Issued in NY
Practice address
116 Admiralty Loop
Staten Island, NY 10309-3962
Phone
(917) 882-7045
Fax
(917) 882-7045
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303507 NY Primary

Addresses

Primary practice location

116 Admiralty Loop
Staten Island, NY 10309-3962

Mailing address

116 Admiralty Loop
Staten Island, NY 10309-3962
Phone (917) 882-7045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112001550 NY Practitioner - Nurse Practitioner 0042440158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

501 Seaview Ave
Suite 200
Staten Island, NY 10305-3400
Phone (718) 663-6400

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
303507NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 25, 2021 Accepting new patients
North Shore - Lij Medical PC CurrentSince Oct 25, 2021 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

501 Seaview Ave
Ste 200
Staten Island, NY 10305
Phone (718) 226-5800

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mvaynshteyn60757@northwell.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1639220528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 ADMIRALTY LOOP",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093962",
            "telephone_number": "917-882-7045",
            "fax_number": "917-882-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 ADMIRALTY LOOP",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093962",
            "telephone_number": "917-882-7045",
            "fax_number": "917-882-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYNSHTEYN",
        "first_name": "MARINA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.